Lithotrity, and its after-treatment / by George H. Porter.

  • Porter, George Hornidge, 1822-1895.
Date:
1867
Catalogue details

Licence: Public Domain Mark

Credit: Lithotrity, and its after-treatment / by George H. Porter. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    removal of detritus. The late Sir Philip Crampton saw the neces- sity of some efficient means of doing so, and not only suggested but employed a most ingenious contrivance, which, in my student days, I saw him use in the Meath Hospital, and which is well described in the number of this Journal for January, 1846, page 22, in the following words:—“ The apparatus consists of a strong glnss vessel of an oval form, and six or eight inches in length, by three in diameter, and capable of holding about a pint and a-half of water; to this vessel is attached a tube of about half an inch bore, furnished with a stop-cock. The air being exhausted by means of an exhausting syringe, and one of Ileurteloup’s wide-eyed steel evacuating catheters being introduced into the bladder, it is next attached to the exhausted vessel; the stop-cock is then turned, and a communication being thus established between the bladder and the glass, the pressure of the atmosphere is by this means brought to bear on the bladder, and supplies an expulsive power, which may be increased to any required amount,” Figure 4, plate I, gives a tolerably accurate idea of this instrument. It has been drawn from the original one, which my colleague, Mr. P. C. Smyly, kinc y placed at my disposal for that purpose. . . . .. The instrument of Mr. Clover, of London, for injection of the bladder, and withdrawal of the injected liquid by suction is such an improvement upon the former means of removing debris by in- jection, that having found the advantages its employment affords in speedy and safe removal of the fragments of calculi, I consider its use an important auxiliary in the after-treatment of lithotrity. It must be admitted that there can be no more important elcmen in the after-management of a case of lithotrity, or a point, more conducive to the success of the operation, than early removal o the detritus, and without injury to the prostate or urethra; an improvements in the surgical appliances for lithotrity aie to oe much encouraged in this direction as well as in the means o primary comminution of the calculus. By crushing the stone, m the first instance, a comparatively smooth and single calculus is converted into several angular and irregular stones; the bladder moreover, having become more or less irritated by instrumental interference, the patient is not much better off than he was be me . the operation. His hopes of relief, therefore, rather depend^ on the removal of the crushed fragments. Every practical lithotntist will bear me out in saying that the delight of a patient is most remarkable when he sees the fragments; and, on the contrary,